Pediatric Ocular Surface Inflammatory Diseases (POSID): Clinical Feature and Practice Patterns

Abstract

Purpose : To investigate the clinical features and practice patterns of POSID, including blepharo- (BKC), herpetic (HKC), and vernal keratoconjunctivitis (VKC) in the United States using the Optum Labs Data Warehouse, a real-world data asset with de-identified administrative claims and electronic health record (EHR) data.

Methods : Patients aged <18 years with BKC, HKC, or VKC and had a clinical encounter between 2018 and 2019 were included. Clinical information from 6 months before to 3 years following the encounter (index date) were analyzed.

Results : 6,116 patients were included. Up to the index date, blepharitis was observed in 5.3%, with higher rates in BKC (13.5%) than HKC (4.9%) and VKC (3.6%) (P<0.001). Giant papillary conjunctivitis was found in 10.4% of BKC, 11.3% of VKC, and only 3.6% of HKC cases (P<0.001). Corneal scarring and ulceration rates were significantly higher in HKC compared to BKC and VKC both before and after the index date (all P<0.001). In the follow-up period, topical corticosteroids were commonly used (high-potency: 14.9%, low-potency: 15.9%), with BKC cases more likely to receive high-potency corticosteroids (P=0.02). Topical immunomodulators were prescribed in 1.7% of cases, and oral antibiotics in 30.6% overall. Antivirals were more common in HKC cases (23.7%) (P<0.001). Surgical interventions for complications were uncommon (n=21, 0.3%), with corneal perforations (<1%) limited to BKC cases.

Conclusions : Key differences in clinical presentation and management exist among POSID diagnoses. Corneal complications were more prominent in HKC. Topical corticosteroids were widely used, with high-potency corticosteroids more prevalent in BKC cases. The limited use of topical immunomodulators suggests the potential for improving treatment approaches.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.